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235 Cards in this Set
- Front
- Back
What is a characteristic sound heard with tracheal collapse?
|
Honking
|
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Tracheal collapse is what type of condition?
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An acquired, end-stage disease
|
|
The sx approach to the trachea is to bluntly dissect which muscles?
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Sternothyroideus and sternohyoideus
|
|
What are some of the surgical methods used to correct tracheal collapse?
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-dorsal membrane plication
-external tracheal splints -internal tracheal splints |
|
The trachea has what type of blood supply?
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Segmental
|
|
When performing surgery on the trachea, which nerve do you need to watch out for?
|
Recurrent laryngeal
|
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External Tracheal spiral splints are placed between the trachea and what other structures?
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Neurovascular structures
|
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What are the disadvantages of the external spiral tracheal splint?
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-extensive surgical approach
-anesthetic risk prolonged post op care and pain -other segment may collapse |
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What is the big advantage to using internal tracheal splints?
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Delivered by catheter...no surgery required
Entire trachea treated at 1 time |
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In adult dogs, how much of the trachea can be resected?
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25% - 50%
(in puppies 20%-25%) |
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What type of sutures must be used in tracheal resection?
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Tension sutures
|
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What device is used post op of a tracheal resection to assist in healing?
|
A harness that holds the dog's head in a downward position
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When anastomozing the trachea, which surface is sutured first?
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Back wall
|
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How do you checks for leaks in the trachea prior to closing?
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Bubble test with saline
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After performing a tracheotomy ot tracheostomy, what activity should the dog never engage in?
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Swimming
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What suture pattern is used to suture the tracheal mucosa to the skin in creating a tracheostomy?
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Mattress
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What is the definition of a diaphragmatic hernia?
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Continuity of the diaphragm is disrupted leading to protrusion of the abdominal viscera into the thoracic cavity
|
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Name the 3 types of diaphragmatic hernias.
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Circumferential, radial, combined
|
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Congenital diaphragmatic hernias are not true hernias because....
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No serosal lining
|
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Congenital diaphragmatic hernias are traumatic how often?
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93% of the time
|
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What are the 3 types of Congenital diaphragmatic hernias?
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-pleuroperitoneal
-peritneo-pericardial -hiatal |
|
When a dog has been involved in a HBC, and has a fx, what other area should you check?
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Diaphragm....2% of dogs with fractures have diaphragmatic hernias
|
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What are the clinical signs of a traumatic diaphragmatic hernia?
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-dyspnea
-tachypnea -cyanosis -orthopnea -muffled heart sounds -borboygmus -vomiting -chronic cough -excercise intolerance -tucked up abdomen |
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In which position would these signs worsen?
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Wheelbarrow
|
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What is the length of time between trauma and diagnosis?
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hours to 6 years
|
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What diagnostic imaging procedures are used to help diagnose diaphragmatic hernia?
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-radiographs (contrast)
-ultrasound -fluoroscopy |
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Fluoroscpy is most helpful in evaluating what type of hernia?
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Hiatal
|
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What are some of the radiographic signs of diaphragmatic hernia?
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-interruption of diaphragmatic outline
-soft tissue density in thorax -gas-filled viscera in thorax -loss of cardiac silhouette -incidental finding |
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Why might you hear borborygmus when auscultating the chest in the case of a diaphragmatic hernia?
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Intestines may be in the pleural space
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Surgical repair of diaphragmatic hernia carries a higher mortality rate if it is perfomed when?
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< 24 hours after the occurrence or > 1 year after the occurrence
|
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Which timing of repair has the highest mortality?
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When performed < 24 hrs
|
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When can diaphragmatic hernia repair be made?
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When the patient is stable enough for anesthesia
|
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How is the success rate of diaphragmatic hernia surgery improved?
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By delaying surgery 1-3 weeks
|
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What is the first step in treating a traumatic diaphragmatic hernia?
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Correct the life-threatening conditions first...
-shock -hypovolemia -hemorrhage/bleeders -cardiac arrhythmia -electrolyte/acid-base balance |
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Why is a traumatic diaphragmatic hernia an emergency?
|
If the stomach has herniated into the thoracic cavity..a dilating stomach will cause complete and rapid collapse of the lungs
|
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What is the advantage of the abdominal approach for repair?
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-more familiar
-provides bilateral access -can be extended by sternotomy or paracostal incision (reqs ventilatory support of patient) |
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What makes the throacic approach more challenging?
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-only 1 side approach (accurate Dx)
-experience with throacic sx -need good visualization -suturing over a convex surface |
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What is the definition of a hernia?
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The protrusion of the abdominal content included in a peritoneal sac through a natural or acquired opening
|
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What are the components of a hernia?
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-hernial ring (ing. ring or muscle)
-hernial sac -hernial content -peritoneal lining |
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Define "eventration."
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Protrusion of the abdominal content through a debilatated area of the abdominal wall due to a surgical or traumatic origin with an intact skin
|
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Define "evisceration."
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The rupture of all the structures constituent of the abdominal wall with the protrusion of the visceral content, through a wound or surgical incision
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What does it mean when a hernia is incoercible?
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Is reduced but pops back out
|
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What is an incarcerated hernia?
|
impossible reduction of the hernia into the abdomimal cavity, with no alteration yet in the blood supply to the hernial content
|
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What is a strangulated hernia?
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Impossible reduction of the hernia into the abdominal cavity with vascular compromise to the protruded viscera
|
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What caution must be taken with a strangulated hernia?
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Do not attempt manual reduction, possible rupture of the involved organ
|
|
What are the clinical signs of umbilical hernia?
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-deformation
-reducible/irreducible -redness/pain -symptoms will depend on the content |
|
When should an umbilical hernia be repaired?
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ASAP
|
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What are the principles of herniorrhaphy?
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-return all viable content to the abdominal cavity
-close the hernial ring to prevent occurrences -obliteration of redundant tissue in the hernial sac -use the patient's own tissues whenever possible |
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What do you do when repairing a hernia, if the edges are necrotic?
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Use scalpel blade to debride
|
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What suture pattern is used to close a hernia repair?
|
Vest over pants
|
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Which hernia type is the most difficult to repair?
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Inguinal hernia
|
|
What is the difference between an indirect and direct inguinal hernia?
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Indirect- herniates into the vaginal process
Direct- herniates into a prescrotal opening |
|
What are some of the DDX's for inguinal hernia?
|
-abscess
-mammary neoplasia -neoplasia from another origin -hematoma -inguinal lymph node -fat -eventration |
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What type of hernia is a cord like structure through the inguinal ring towards the scrotum?
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Scrotal hernia
|
|
Diagnosis of a scrotal hernia is made in which position?
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Dorsal recumbency
(use U/S when in doubt) |
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A femoral hernia can be palpated in which position?
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Standing on hind legs
|
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A perineal hernia is a rupture of what?
|
Of the pelvic diaphragm
|
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What is a typical signalment for a patient with perineal hernia?
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-male (93%)
-adult (7-9 years) -non-castrated (95%) -2/3 unilateral -right sided |
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What are some of the possible causes of perineal hernia?
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-neurogenic atrophy
-senile atrophy -myopathies -endocrine disorders -prostatomegaly -constipation & tenusmus |
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A perineal hernia can often contain what structure?
|
Urinary bladder
|
|
Perineal hernias in the dog can be of what configurations?
|
-flexure
-saccule -dilatation -diverticle (real, false) |
|
Which ligament is not found in the pelvic diaphragm of the cat?
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No sacrotuberous ligament
|
|
Clinical signs of perineal hernia include what?
|
-constipation
-tenesmus -inflammation -edema -dysuria -anal dilatation -rectal mucosal prolapse |
|
What 2 approaches are used for perineal hernia repair?
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-perineal
-lateral do not use trendelnburg |
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How many sutures are needed to close the perineal hernia repair?
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7
|
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What are the post op complications are perineal hernia repair?
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-rectal prolapse
-incontinence -dehiscence -sciatic nerve lesion |
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What is the reoccurence rate of perineal hernia?
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10-46%
|
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Sciatic nerve lesions occur 5% of the time from perineal hernia repair. What iatrogenic cause can affect the sciatic nerve?
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Entrapment by sutures
|
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What is the most common perineal tumor of intact male dogs?
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Perineal gland adenoma
|
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Which perineal neoplasia is most common in female dogs?
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Aprocrine cell adenocarcinoma of the anal sac or aprocrine gland adencarcinoma
|
|
Aural surgery is a contaminated procedure, therefore what type of perioperative drugs are given?
|
Antibiotics
|
|
What are the treatment options for an aural hematoma?
|
-incise, evacuate hematoma, suture
-aspirate hematoma, steroid injection into space? place pressure bandage? -cannula/catheter drainage |
|
What conditions of the external ear are indications for surgery?
|
-otitis externa
-stricture of the ear canal -neoplasia of the ear canal |
|
Clinical signs of otitis externa usually always include what?
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Shaking of head, scratching
|
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How are acute cases of otitis externa treated?
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Medically- clean ear, systemic abi for 3 weeks
treat for mites or fungal infection |
|
What surgical approaches are used for treatment of chronic otitis externa?
|
-lateral ear canal resection
-vertical ear canal resection -total ear canal ablation, combined with lateral bulla osteotomy (TECA-LBO) |
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What is the name of the lateral ear canal resection procedure?
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Lacroix or Zepp
|
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When performing a vertical ear canal resection, which facial structures do you need to watch for?
|
facial nerve
parotid gland |
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The final suture line of the vertical ear canal resection forms what shape?
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A "T"
|
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Which instrument is used to remove the medial bony portion of the bulla during the TECA LBO procedure?
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Rongeurs
|
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What is a nasopharyngeal polyp?
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Inflammed and hyperplastic epithelium of the bulla, projects into the pharynx through the auditory tube
|
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A nasopharyngeal polyp could be confused with what?
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Neoplasm
|
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Cannula drainage of a hematoma can be performed using what type of cannula?
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A teat cannula
|
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What condition can occur secondarily to otitis externa?
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Otitis media
|
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True or False. In the cat, otitis media is always preceeded by otitis externa
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false- otitis media can occur on its own
|
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What are some of the clinical signs of otitis media?
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-head tilts, esp if associated with nystagmus, circling, vestibular dysfunction
-facial nerve deficits -nausea, vomiting Horner's |
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How should a nasopharyngeal polyp be treated?
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-pulled back into the bull and removed with the epithelium
-if polyp resected in pharynx or external ear canal. stalk should be pulled into the bulla and removed with epithelium |
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What are the indications for performing a bulla osteotomy?
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-otitis media
-nasopharyngeal poly -neoplasm of epithelium of bulla |
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What will happen if the tissue lining of the bulla is not removed during a bulla osteotomy?
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Infection will return
|
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What is different about the bulla of the cat vs the dog?
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In the cat the bulla is divided into craniolateral and craniomedial compartments....both must be opened
|
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What are potential complications from a bulla osteotomy?
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-Horner's- esp in cats, resolves in 2-3 weeks
-facial nerve paralysis -vestibular dysfunction -superficial wound infection |
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Describe the architecture of the sublingual salivary gland
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-caudal is monostomatic
-rostral is polystomatic |
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Name the major salivary glands in the dog
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-partoid
-mandibular -sublingual -zygomatic |
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What additional major salivary gland is found in the cat?
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Molar salivary gland
|
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What are some of the minor salivary glands?
|
-lingual
-labial -buccal -palatine |
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The minor salivary glands open into where?
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Directly into the oral cavity
|
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What are some of the disease conditions of the salivary system?
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-mucocele
-parotid fistula -sialotliths -sialoadenitis -canaine necrotizing sialometaplasia canine sialoadenosis -neoplasia |
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On physical exam, what is the appearance of a salivary system problem?
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Notable swelling
|
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A needle aspiration of a salivary gland cyst will give a fluid that leads to what common name?
|
Honey cyst
|
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what radiographic procedure can demonstrate the salivary system, helping to rule out a rupture of the duct?
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Sialogram
|
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What is a salivary mucocele?
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Subcuntaneous (submucosal) accumulation of saliva with non-epithelial non-secreting lining
|
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What is the most common disease of the salivary system in the dog and cat?
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Salivary mucocele
|
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Which gland is most affected?
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Sublingual salivary duct (monostomatic portion)
|
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90% of salivary duct ruptures occur on which side?
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Left
|
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What is the most common location for a sublingual gland mucocele?
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Cervical
|
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What is a ranula?
|
sublingual accumulation
|
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What is a sequelae of of pahryngeal mucocele?
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Obstructs the airway....drain first
|
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A cat with a zygomatic gland mucocele will have swelling in what region?
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Periorbital
|
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What are the clinical signs of a mucocele?
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Soft, non-painful swelling
(pharyngeal= respiratory distress) |
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What is the definitive tx for salivary mucocele?
|
Surgical removal of the involved gland
|
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After removal, what is the chance of re-occurance of a mucocele?
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Less than 5%
|
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What is a sialolith?
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Salivary duct stones
|
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What is the most commonly affected gland in the dog?
|
Parotid
|
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How can you differentiate the swelling of a mucocele from the swelling of a sialolith?
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Sialolith is painful
|
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How is a sialolith removed?
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Through an oral incision over the duct
|
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Sialoadenitis is usually a secondary condition due to what?
|
Trauma or systemic infection
|
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Which gland is most affected with sialoadenitis?
|
Zygomatic salivary gland
|
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What is the current thought as to the cause of a parotid fistula?
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Result of trauma to the parotid duct
|
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What is the tx for parotid fistula?
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Ligation of the parotid gland...results in atrophy by day 5
|
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Salivary gland neoplasia is uncommon..which breed of cat is more commonly affected?
|
Siamese
|
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What other conditions can cause salivary gland enlargement?
|
-canine necrotizing sialometaplasia
-canine sialadenosis |
|
|
|
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What are 3 possible causes of failure of erection in the dog?
|
-psychological constraints
-pain -androgen insufficiency (uncommon) |
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What are some cause of failure to ejaculate seen in the dog?
|
-age (young dogs may copulate before maturity)
-pain -effects of pharmacological agents -retrograde ejaculation |
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Retrograde ejaculation is rare, what drugs are used to tx it?
|
-sympathomimetic drugs
(phrenylpropanoloamine, pseudoephedrine) |
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What are the cause in failure to copulate seen in dogs?
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-age (too young, too old)
-overuse -psychological constraints |
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What is the definition of laryngeal paralysis?
|
Failure of the laryngeal cartilages to abduct on inspiration as a result of degeneration of the recurrent laryngeal nerve and paralysis of the cricoarytenoideus dorsalis muscle
|
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What is the eitiology of laryngeal paralysis?
|
Wallerina degeneration of the recurrent laryngeal nerve from unknown causes
|
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In which species is laryngeal paralysis see?
|
Medium and large breed dogs, occasionally cats
associated with hypothyroidism in dogs |
|
What history or clinical signs will be seen in cases of laryngeal paralysis?
|
-inspiratory dyspnea
-stridor -change in voice -cyanosis -hot weather exacerbates signs |
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What surgical approaches can be used to reapair laryngeal paralysis?
|
-partial areytenoidectomy (ventriculocordectomy)
-arytenoid cartilage lateralization (tie back) -laryngoplasty ( castellatated laryngofissure) |
|
Why is an arytenoidectomy done partially?
|
To reduce the chance of aspiration
|
|
For the arytenoid cartilage lateralization technique, where do you tie the cartilage?
|
Tie back to the thyroid and areteynoid with non-absorbable sutures
|
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What are the possible complication of arytenoid cartilage lateralization?
|
Aspiration pnemuonia (do only 1 side)
Failure to correct condition -inadequate lateralization -failure to correct associated hypothyroidism -misdiagnosis of cause of dyspnea |
|
What is brachecephalic airway syndrome?
|
-primary upper airway characteristics of stenotic nares, elongated soft palate and hyoplastic trachea
-secondary syndrome include everted laryngeal saccules and laryngeal collapse -signs of upper airway obstruction |
|
How could you treat brachycephalic airway syndrome medically?
|
-weight loss
-reduced exercise -harness -steroid for short term -sedatives -avoid hot environment |
|
What 2 surgical procedures could be performed on stenotic nares?
|
-alaplasty
-alapexy |
|
How is alapexy performed?
|
Two elliptical incisions are made and sutured together on the nare side...will pull nares open
|
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How do your treat the elongated soft palate surgically?
|
Resection
remember to cut less than you think, healing will cause the palate to retract further Folded flap palatoplasty |
|
What is the surgical treatment of choice for laryngeal collapse?
|
Permanent tracheostomy
|
|
With an otoscope, ho far into the nose can you see?
|
Rostral 1/3 of cavity
|
|
How would you perform a core biopsy of the nasal cavity?
|
-under anesthesia
-measure cannula against muzzle before inserting -12 cc syringe, cannula |
|
A dorsal approach to exploratory rhinotomy allows access to which structures?
|
Rostral nasal cavity and sinuses
|
|
What would a ventral approach to exploratory rhinotomy give you access to?
|
Entire nasal passage, including area caudal to the ethmoid turbinates
|
|
Why would an exploratory rhinotomy be performed?
|
-establish drainage, remove f.b.
-diagnostic procedure for biopsy and culture -may be indicated for treatment (adenocarcinoma) |
|
How do you define the term fracture?
|
Interruption of the continuation of a bone
|
|
What terms are used for the general classification of bone fx?
|
-plane
-direction -fragments |
|
Addtional classfication of fx include the fractures reducibility and...
|
-stability
-bone protrusion (open or closed) |
|
When discussing a fx with a colleague over the phone it helps to speak in a common language which would include telling him/her the bone and place of fx and what else?
|
-number of fragments
-soft tissue status (open/closed) |
|
When classifying long bone fractures, the soft tissue wounds in an "open" fracture can be classified into how many categories?
|
4
I,II, IIIa, IIIb, IIIc |
|
What are the definitions of soft tissue categories I and II?
|
I wound < 1 cm, clean
II wound > 1 cm moderate soft tissue trauma |
|
What are the definitions of open soft tissue classifications of III a,b,c
|
IIIa: severe soft tissue trauma, wound coverage possible
IIIb: tissue loss, bone exposed, periosteal stripping IIIc: blood supply impaired, arterial repair necessary |
|
What is the name of the classifications of physeal fractures?
|
Salter Harris
|
|
What are SH I and SH II fracture?
|
SH I: fx along the physis
SHII: fx along physis into metaphysis |
|
What are SH III and SH IV fractures?
|
SH III: fx at physis and epiphysis
SH IV: fx at physis, metaphysis and epiphysis |
|
What are SH V and SH VI fractures?
|
SH V: compression of the physis
SH VI: compression 1 section of the physis |
|
Why does a bone fracture?
|
Increasing load and deformation from which the bone cannot recover- energy is released at fx site
|
|
What is the difference in healing between soft tissue and bone?
|
Soft tissue heals by scar formation
Bone heals by forming new bone |
|
What are the goals of fracture repair?
|
-anatomical reduction
-stable fixation -blood supply preservation -early mobilization |
|
Why is early mobilization important?
|
To reduce the amount of atrophy
|
|
What 3 patterns of healing are seen at a fracture site?
|
-adequate blood supply
-spontaneous healing -mechanical stability (osteosynthesis) |
|
Unstable fractures are subjected to natural stabilization which include what processes?
|
-muscular contraction
-resorption of bone edges -deposition of suitable tissues -prominent callus formation |
|
How is an unstable fracture defined?
|
More than one fragment
|
|
True or false. Unrestricted movement will cause a larger bone callus to form.
|
True
|
|
The type of tissue cells that respond to a fracture is determined by the what of the fracture gap?
|
Strain (or movement) or deformation of the gap
100% = non-union 10% = fibrous/granulation 2-10% = cartilage formation 2% = direct bone formation |
|
What are the 3 phases of healing in an unstable, unrestricted movement fracture?
|
indirect- second healing
1. inflammation 2. repair 3. remodeling |
|
Phase 1 of indirect secondary healing, inflammation, lasts for how long and includes what events?
|
lasts 3-4 days
-hemorrhage -bone ischemia -necrosis -vascular endothelium angiogenesis |
|
The vascular response to healing is affected by what?
|
Soft tissue injury
|
|
Blood is supplied to the healing bone fracture site by what organ?
|
Muscles
|
|
In phase 2 of indirect secondary healing, repair, what happens to the hematoma at the fx site?
|
Is replaced with granulation tissue (elongates to twice its length)
Granulation tissue rapidly infiltrated by collagen |
|
3 weeks after a fracture, what type of callus has formed?
|
a bridging or soft callus
|
|
Mineralization of the gap occurs in what direction?
|
From the ends to the center of the gap
|
|
What substances do the mitochondria release during fx repair?
|
-calicum containing graules (hypoxic environment)
-Ca phosphate forms apatite micro crystals |
|
What occurs during phase 3 of indirect secondary healing of a fx?
|
Remodeling- slow morphological adaptation for function and strength
|
|
Remodeling of the bone is dependent of the mechanical forces placed on it. What is the name of these forces (converted to energy)
|
Piezoelectricity
|
|
Restricted movement of a healing fracture will have what benefits?
|
-osteogenic intensity
-increased bone density -biomechanical strength |
|
A stable bone fracture has how many fragments?
|
2
|
|
What is the functional unit of bone?
|
osteon
|
|
In stable fractures with contact healing, new bone forms in which direction?
|
Axial
|
|
The fx gap in the contact healing process is bridge with bone by what structure?
|
Cutting cone
|
|
What comprises the front and back end of the cutting cone?
|
Front: osteoclasts- cuts channel to other side of fx
back: osteoblast (lays down new bone) |
|
Contact healing occurs if the gap is of what size?
|
< .01 mm/ strain <2%
|
|
A stable fracture gap up to 1 mm (strain 2%) is healed by what process>
|
Gap healing
|
|
What are the step in gap healing?
|
-gap fills with intramembranous bone (perpendicular to long axis)
-2 weeks, gap filles, fragments unite -3-8 weeks haversian remodeling -osteons proliferate longitudinally |
|
What are some of the conditions that influence bone healing?
|
-metabolic dz
-hormonal imbalance -neoplasia -nutrition -protein deificiecy -diabetes -age -hypoxia -drugs -infection soft tissue at site |
|
Will bones heal in the presence of infection?
|
Yes
|
|
The healing pattern of a bone fx will differ with what?
|
The method of fixation
|
|
Fractures heal faster with what?
|
Limited motion
|
|
What is a key to fracture healing?
|
Preservation of blood supply
|
|
What is the best method to simulate fracture healing?
|
Cancellous bone graft
|
|
Why is a Cancellous bone graft so helpgul in healing?
|
-provides a scaffold for osteoproginator cells
-contains viable osteoproginator cells -bioactive bone including factors -no immune reactions -no transmitted dz |
|
Why isn't stripping the periosteum a good technique for stimulation of bone healing?
|
Decreases blood supply
|
|
When do you perform the cancellous bone graft?
|
At the end of the fx repair sugery
|
|
What is the theory of the biological approach to osteosynthesis?
|
-avoid soft tissue trauma
-avoid rigid fixation -vascular injury in minimized -periosteal stripping is limited |
|
What orthopedic device will give soft tissue integrity and less rigid fixation?
|
IM pins
interlocking nails external fixators ring fixators |
|
Fractures located where near more rigid fixation?
|
Closer to joints
|
|
Withour rigid fixation near joints, what disease can develop?
|
DJD
|
|
Why is "over plating" a fracture a detriment to healing?
|
The forces of walking (healing) go through the plate not the bone
|
|
What are 3 potential complications to bone healing?
|
-delayed union
-non-union -malunion |
|
What factors can cause delayed union of a fracture?
|
-impaired blood supply
-movement -initial management -wrong ortho technique -implant failure -inadequate post op care |
|
What are the clinical signs of delayed union of a fx?
|
-use of limb
-pain -movement at site -muscle atrophy |
|
What radiographic signs of delayed healing might be seen?
|
Sequential films might show...
-limited bone resorption -mineralized callus -open medullary cavity -evidence of fx line |
|
What is the treatment for a delayed union of a fx?
|
-confine, wait and observe
-reoperate -cancellous.cortical bone graft -biomaterials -external coaptation, internal fixation |
|
In the case of a nonunion failure of fx healing, what type of bone is viable?
|
-hypertrophic
-slightly hyperthrophic -oligotrophic |
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In the case of a nonunion failure of fx healing, what type of bone is non- viable?
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-dystrophic
-necrotic -defect -atrophic |
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What are some of the causes of non-union fracture healing?
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-impaired blood supply
-movement -initial management -wrong ortho technique -implant failure -inadequate post op care -interposition of soft tissue -comminuted fractures -open fx/infection -metabolic dz |
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How do you diagnose non-union?
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-lamness
-muscular atrophy -movement of fx site -pain |
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How is non-union of a fx seen radiographically?
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-persistant gap
-sclerotic ends -closed medullary cavity -sequestra |
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What is the treatment for non-union of a fx?
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-surgical approach
-debridement -implant removal -osteotomy of sclerotic ends -open medullary cavity -lavage -bone graft -rigid fixation |
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What is amlunion of a fx?
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Fracture heal without anatomical alignment
|
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What hx and clinical signs are seen in malunion?
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-gait abnormalities
-regional deformation -lameness radiographically: -angular deformity -shortening -rotational deformity |
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What is the most common cause of post traumatic osteomyelitis?
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bacterial, nosocomial infection
(of open fxs) |
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What 2 general conditions result in bone infection?
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contamination + inadequate blood supply
|
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What develops on an ortho implant that promotes osteomyelitis?
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Biofilm which allows bacterial adhesions
|
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what are the clinical signs of osteomyelitis?
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-lameness
-fever -depression -anorexia -local pain -swelling |
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What signs are seen if the osteomyelitis infection if chronic?
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-local signs only
-fistulous tratcs |
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What are the radiographic signs of ostemyelitis?
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-periosteal proliferation
-bone resorption -areas of increased density -bone lysis -sequestra -loose implants |
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What re the treatment goals for a case of osteomyelitis?
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-culture and sensitivity
-improvement of fx site -abi therapy |
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What steps can you take to help heal osteomyelitis?
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-aggressive debridement
-elimination of biofilm -implant removal -remove foreign material -lavage -open drainage - muscle flaps -rigid fixation |
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What is the average age of 55% of dogs and cats with growth plate factures?
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Under 1 year
|
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Why does angular limb deformity occur after a physis fracture?
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Bone stops growing on one side due to fx, other bone (radius/ulna) continues to grow and bends
|
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Why is it important to make a fast diagnosis in growth plate fractures?
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Bone callus forms fast!
|
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what steps should you take in the case of a growth plate fx?
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-immobilize
-accurate anatomical reconstruction -bne soft/friable -prevent further fragment injury -avoid cartilage damage -select proper ortho method |
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Which ortho device provides anti-rotation for repair of a growth plate fx?
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Lag screw
|
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Is a SH I fracture likely to close the physis prematurely?
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No, unlikely
|
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A SH II (in a dog over 6 months) is likely to cause what kind of defect upon healing?
|
Angular limb deformity due to callus
|
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Which growth plate fx is an emergency and requires immediate attention?
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SH III through the epiphysis
|
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If a SH III fx is not perfectly reduce, what will occur in the future?
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Arthritis
|
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Which SH fx type is very unstable and requires immediate reduction?
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SH IV, through metaphysis, physis and epiphysis
|
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How quickly must sx be performed to correct a SH V fracture?
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Does not require suregry
|
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Why are articular fxs in adults difficult to deal with>
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-fx reduction must be exact
-need special instruments -articular cartilage has low healing potential -for cartilage nourishment movement and weight bearing are needed |
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Joint osteosynthesis should not be attempted unless....
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You have precise knowledge of the joint's anatomy
|
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Anatomically, when should osteosynthsis not be undertaken?
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-when the fx cannot be anatomically reduced
|
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What is the benefit to early mobilization in fx healing?
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-prolonged immobilization leads to joint stiffness
-exercise stimulates cartilage healing -(pain prevents early mobilization) -bandaging may be necessary |
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What is the prognosis for an articular fx in an adult?
|
-unfavorable
-long term arthrosis likely -depends on joint that is fx and surgeon's expertise -damage to cartilage |